BROWNING 175 Internal Appearances.-J!he~ brain is hyperaemie, and the vessels of its membranes are injected. Xtxe lungs are distended like balloons, overlap the heart and protrude out of the thorax on laying it open by the removal of the sternum. They are often indented by the ribs, are heavy, oedematous and spongy to the feel, and pit on pressure with the finger. They are of a pale grey colour with reddish stains, and on section exude a large quantity of a frothy, blood- stained fluid. Minute, punctiform sub-pleural and pericardial ecchymoses noted in other forms of asphyxia are seldom f ound in cases of drowning. The larynx, trachea and bronchial tubes usually contain a fine, white froth, and may contain some foreign matter, such as sand, mud or fragments of aquatic plants. Their mucous membrane is usually red and congested. J^gJii appears within two minutes of submersion, and its quantity varies according to the length of submersion and the violent respiratory efforts. Particles of food may be found regurgitated in the air-passages owing to the vomiting set up by the imbibition of water especially if the stomach was full at the time of drowning. During putrefaction the watery fluid from the lungs may transude into the pleural cavities. The heart presents the appearance usually found in death from asphyxia ; the left side is usually empty, the right side is full, and the large veins are gorged with blood which is dark in colour and unusually fluid owing to admixture of water. Alexander C. Gettler15 suggests the determination of the chloride, content in the blood of the right and left chambers of the heart as a specific * test for drowning. This test is based on the fact that the water enters into the lungs during drowning, and dilutes the chloride content of the blood in the heart by osmosis. Normally the chloride content of the right and left chambers of the heart is almost the same, the greatest difference being 5 mg. in 100 cc. of blood. In cases of drowning the difference is always much more than 5 mg., ranging from 19 to 294 mg. This difference depends on the amount of water going into the lungs, and also on the time interval between the entrance of water into the lungs and death. The longer this time interval, the more water passes to the left chamber of the heart. In cases where drowning occurs in salt water, the left chamber of the heart shows a higher chloride content and in cases where drowning occurs in fresh water the left chamber shows a 'lower chloride content. It must be remem- bered that persons who die of shock immediately after submersion in water may not show this difference in the chloride content. It must also be borne in mind that water cannot get into the left side of the heart, if the body is thrown into water after death. Ifee jaresence in the stomach of a certain quantitiy of water is regarded as an important sign of death, particularly if the water possesses the same characteristics as that in which tihe body was found immersed, and contains sand, mud, algse, weeds, fine shells, etc. ItJ[s almost impossible for water to get into the stomach, if a body is submerged after death. In rare cases, it is possible that the water found in the stomach may have been drunk by the deceased immediately before submersion occurred, On the other hand, water may not be present in the stomach, if the person TEST from syncope or shock, or became unconscious immediately after falling into water, so that he could not struggle and swallow water in the act of drowning. There will also be no water in the stomach, if the body has undergone putrefaeMo^ for water, even if it is present in the stomach, is forced out by the pres of the gases of decomposition. In Northern India, it is not usual to 15. Jour. Amsr. Med. Assoc^ Nov. 1% 1921, p. 1,650.